Pharm Flashcards
what is the half life
time it takes for plasma concentration or the amount of drug in the body to be reduced by 50%
what drug levels are increased by grapefruit
nifedipine
verapamin
statins
midazolam
SSRIs
what drugs prolong qt interval
ondansetron
haloperidol
antidote for lead
succimer
local anesthetics end in what?
-caine
opioids side effects (MORPHINE)
miosis
out of it
resp depression
pruritus, pneumonia
hypotension, headache
infrequent elimination
nausea and nervousness
emesis
what kinds of drug is buprenorphine & nalbuphine
opioid agonist-antagonist
when would you use buprenorphine
mild to moderate pain, opioid addiction
less euphoric effect
less chance of abuse
what kind of drug is naltrexone
opioid antagonist
s/s of ASA toxicity (salicylism)
tinnitus
sweating
headache
dizziness
metabolic acidosis
when do we give aspirin to kids
kawasaki’s disease
what drugs can help lower bp (ABCD)
ACE inhibitors and ARBS
beta blockers
CCBs
diuretics
can you take ACEs or ARBS during pregnancy
no
what are the nonselective CCBs
verapamil and diltiazem
what are the effects of the non selective CCBs
cause vasodilation of the blood vessels, increasing coronary perfusion
in the heart - slow HR, slow AV node conduction, decrease force of contraction
what drugs are nifedipine, amlodipine, etc.
selective CCBs - only act on blood vessels not the heart!
side effects of selective CCBS?
dizziness, edema
gingival hyperplasia
reflex tachy
does hydralazine dilate the veins or arteries
arteries
what are the arterial AND venous dilators
nitrates (nitroglycerin, nitroprusside)
can you take calcium supplements with CCBs
yes! do not need to discontinue
which CCBs can cause constipation
nondihyrdos (vera and dil)
what kind of drugs are procainamide and lidocaine
sodium channel blockers
what kind of drug is amiodarone
K+ channel blocker
when would you use amiodarone
V tach if patient is awake and alert
PVCs
AEs of amiodarone
Liver, thyroid, pulmonary toxicity
when do you use adenosine
SVT
how do you administer adenosine
rapid push
what should you expect after adenosine
period of asystole
patient will feel like someone kicked them in the chest
MOA of digoxin
increases contractility while decreases HR
therapeutic range for digoxin?
.5-2
early s/s of digoxin toxicity
n/v
anorexia
yellow/green halos in vision
late s/s of digoxin toxicity
bradycardia leading to fatal arrythmias
who are at risk for digoxin toxicity
hypokalemia
hypomagnesemia
hypercalcemia
digoxin antidote
digoxin immune fab
what are inhaled glucocorticoids used for (i.e. budesonide)
for asthmatics to take regularly
not for acute attacks!
what are systemic glucocorticoids used for (i.e. methylprednisolone)?
acute attacks
best to use <10 days
what kind of drugs is montelukast
leukotriene receptor antagonist
when do you take montelukast
long term control, cannot abort ongoing attack
SE of montelukast
liver injury
neuropsychiatric effects (including SI)
churg-strauss syndrome
what do monoclonal antibodies (like omalizumab) act on
IgE –> reduce to decrease inflammatory reaction
how long do you have to monitor someone after monoclonal antiboties
2 hours after first 3 doses and 30 mins after all other doses
monitoring for anaphylaxis
examples of long acting beta 2 agonists
salmeterol
formoterol
side effects of beta 2 agonists
relaxation of smooth muscle in airways
but also tachycardia angina, tremor
what are theophylline and aminophylline used for
asthma maintenance
what kind of drug is ipatropium and what is it used for
anticholinergic
used for asthma and COPD, can be used for acute attack
what do alpha antagonists end with
-osin
when do you use apha antagonists
HTN
BPH
raynaud’s
pheochromocytoma
why are beta blockers used in caution with diabetics
will mask symptoms of hypoglycemia
which beta blockers are safer for asthmatics and diabetics and why
metoprolol, carvedilol, esmolol, labetalol,
because they are beta 1 selective
what do cholinesterase inhibitors end in and what is there effect
-stigmine
increase cholinergic effects - rest and digest
who do you avoid cholinergics with
intestinal obstruction
uti
asthma
hyperthyroidism
hypotension
do you take cholinergics with food
no! take on empty stomach
cholinergic drug side effects (DUMBELS)
diaphoresis and diarrhea
urination
miosis
bradycardia, bronchospasm
emesis
lacrimation
salivation
how do you treat muscarinic posioning
atropine (anti-cholinergic)
how do anticholinergics like oxybutynin impact urinary system
helps with urination retention
you would take oxybutynin for overactive bladder
what it is the antidote for anticholinergic toxicity
physostigmine
what kind of drugs are donepezil and rivastigmine
cholinesterase inhibitors
help improve symptoms in mild and moderate AD like improving memory and reasoning
what is a side effect of phenytoin
gingival hyperplasia
can you take phenytoin during pregnancy
no
what are 5 long term anticonvulsants
phenytoin
fosphenytoin
carbamazepine
phenobarbital
valproic acid
what should you use to abort a seizure
lorazepam
diazepam
what should you not take with anticonvulsants
antacids
H2 receptor antagonists MOA
block release of stomach acids
can you take H2 receptor antagonists with meals
yes
when should you take PPIs
30-60 mins before meals
what should you report for PPIs
black tarry stools
when should you take sucraflate
1 hour before meals or 2 hours after and at bedtime
what drugs does sucralfate decrease bioavailability of
warfarin
digoxin
phenytoin
levothyroxine
separate drugs by at least 2 hours!
what kind of drug is bisacodyl
stimulant laxative
what would you use for chornic constpiation
polyethylene glycol
mag hydroxide, mag citrate
mag sulfate
lactulose
what would you take to reduce diarrhea
loperamide - activates opioids receptors
what kind of drug is ondansetron
anti-emetic
serotonin antagonists
how do you delivery ondansetron
slow!
fast push can cause QT prolongation and VT
what are dopamine antagonists used for nausea
promethazine
chlorpromazine
how often do you change TPN tubing and bag
q 24 hours
if you run out of TPN, what do you give
dextrose 10% at same rate as TPN was running
ae of furosemide
hyponatremia
hypochloremia
hypokalemia
ototoxicity
dehydration
which drugs trigger beta cells to release insulin
sulfonylureas (glimepiride, glyburide)
what kind of drug is metformin
biguanide
what is rosiglitazone used for
reduces glucose production and increases insulin receptor sensitivity
how does metformin work
inhibit liver glucose production and reduce intestinal absorption of glucose
therapeutic aptt on heparin
1.5-2x normal
normal = 30-40 seconds
heparin antidote
protamin sulfate
door to TPA time
60 mins
what is compatible with blood
normal saline
when do you take vitals during blood admin
before
during
after
what are augmentin and zosyn
beta lactamase inhibitors + antibiotics
if you take valproate, what antibiotic should you avoid
carbapenems (i.e. meropenem)
when do you use doxycycline
roxy mt spotted fever
chlamydia
cholera
lyme
anthrax
h. pylori
what are nursing considerations for tetracyclines
teeth staining
photosensitivity
poorly absorbed when taken with minerals
what do macrolide antibiotics end in
-mycin
what do aminoglycoside anitbiotics end in
-icin
side effects of aminoglycosides
ototoxic!
monitor for tinnitus
when do we usually give sulfonamides
UTIs
nursing considerations: sulfonamies
hypersensitivity reactions
blood dyscrasia
kernicterus (avoid in infants and later in pregnancy)
nephrotoxic (drink lots of water!)
what organ does vancomycin affect
kidneys! it is nephrotoxic
what are 2 drugs that work against TB
isoniazid
rifampin
isoniazid nursing considerations
hepatoxicity
peripheral neuritis
can raise some levels of anti-seizure drugs
what drug turns bodily fluids red-orange
rifampin
what drugs does rifampin mess with
accelerates metabolism of HIV drugs
reduce effectiveness of OCs and warfarin
why would you take amphotericin
systemic fungal infections
nursing considerations for amphotericin
highly renal toxic
give with one liter of saline
IV only
what is the longest acting benzo
diazepam
what is the shortest acting benzo
midazolam
side effects of TCAs
tachycardia
cardiac effects (prolonged QT)
anticholinergic effects
sedation/sexual dysfunction
what should you avoid when administering lithium
no NSAIDS!
5 nursing considerations of haloperidol
EPS
tardive dyskinesia
neuroleptic malignant syndrome
prolong QT
CT in pregnancy
s/s of neuroleptic malignant syndrome
high fever
rigid muscles
what 2 drugs are used as tocolytics
terbutaline
mag sulfate
when can you give ibuprofen to a peds patient
not before 6 months d/t immature liver
what is oseltmaivir
tamaflu
in low doses where does epi work
beta 1
in high doses where does epi work
beta 1 and alpha 1
what receptors does norepi work on
alpha 1 leading to peripheral vasoconstriction
use for shock and hypotension
when do we use dopamine in critical care
shock, hypotension, trauma
high doses cause vasoconstriction to increase BP
what is third line in septic shock
vasopressin
what will low doses of dopamine do
increase renal blood flow
when is milrinone used
cardiogenic shock
decreased CO
congenital/acquired heart defects
when heart is not strong enough to maintain adequate cardiac output
MOA of milrinone
phosphodiesterase inhibitor –> usually breaks down camp so inhibiting allows more cells of heart muscle to contract
how often do you change IV tubing for a CVC
q 96 hours or per facility protocol
how often do you do CVC dressing changes
weekly or more often
sterile!
what pt position do you place and remove a CVC
trendelenburg
how often do you change bag and tubing for TPN
q24 hours
when is s3 heard
systolic HF
when is s4 heard
diastolic HF
where do you assess macewans sign
junction of the frontal, temporal, and parietal bones
what 6 vaccines are given at 2 and 6 months
Dtap
rotavirus
ipv
pcv13
hep b
hib
Dripping in hep b and hib
4 month vaccines
Dtap
rotavirus
ipv
pcv
hib
dripping in hib
12 month vaccines
VAMP hib
varicella
hep A
MMR
pcv13
hib
4-6 vaccines
MID v
MMR
IPV
Dtap
varicella
when do you start getting annual flu shot
6 months
what are the live vaccines
MMR
varicella
rotavirus
palivizumab (for RSV)
many vaccines ready to pounce!
when does colorectal screening start
50+
when is breast cancer screening started
> 40
what family planning method increases risk for TSS
diaphragm
what is ribavirin used for
to treat hep c
can an LPN give rhogam
no - blood product
do you need to take your blood sugar before taking metformin
no because it does not cause hypoglycemia!
does calcitonin increase or decrease calcium levels
decrease
what is Phenazopyridine
urinary tract analgesic
